Clinical evaluation of a new technique for custom-made spacers in septic two-stage revision of total hip arthroplasties
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Clinical evaluation of a new technique for custom-made spacers in septic two-stage revision of total hip arthroplasties. / Mederake, Moritz; Hofmann, Ulf Krister; Fink, Bernd.
in: ARCH ORTHOP TRAUM SU, Jahrgang 143, Nr. 8, 08.2023, S. 5395-5403.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Clinical evaluation of a new technique for custom-made spacers in septic two-stage revision of total hip arthroplasties
AU - Mederake, Moritz
AU - Hofmann, Ulf Krister
AU - Fink, Bernd
N1 - © 2023. The Author(s).
PY - 2023/8
Y1 - 2023/8
N2 - INTRODUCTION: In septic two-stage revision surgery, success depends on numerous factors. Key steps are the procedure of ex- and reimplantation and the choice of spacer in the interim phase. The latter is still a matter of debate. Recently, we showed the microbial non-inferiority of a spacer technique using prosthetic cemented implants with an individualized antibiotic mixture in the cement applying a mechanically inferior cementation method. The aim of the present study was to evaluate the clinical results of these spacers in view of either an endofemoral or a transfemoral procedure.MATERIALS AND METHODS: Our collective consisted of 86 patients (45 endofemoral and 41 transfemoral procedures). The collective was analyzed with respect to complications, reinfection rate and clinical status at the end of the interim phase. Results of an endofemoral and transfemoral approach were compared.RESULTS: With a median Staffelstein-Score of 60 (range 31-81) at the end of the interim phase, the first clinical results are promising. The reinfection-free rate after a median follow-up of 50 months was 90%. Spacer-related complications occurred in 8% of the total collective. Comparing the endo- and transfemoral procedure, there were no statistical differences in complications or regarding the clinical and infectiological outcome.CONCLUSIONS: In this study, we were able to show good clinical results for the presented spacer technique. With no relevant difference in outcome, the decision for an endofemoral or transfemoral technique can be based on technical deliberations. Further prospective comparative studies are necessary to show the clinical benefit of this procedure.
AB - INTRODUCTION: In septic two-stage revision surgery, success depends on numerous factors. Key steps are the procedure of ex- and reimplantation and the choice of spacer in the interim phase. The latter is still a matter of debate. Recently, we showed the microbial non-inferiority of a spacer technique using prosthetic cemented implants with an individualized antibiotic mixture in the cement applying a mechanically inferior cementation method. The aim of the present study was to evaluate the clinical results of these spacers in view of either an endofemoral or a transfemoral procedure.MATERIALS AND METHODS: Our collective consisted of 86 patients (45 endofemoral and 41 transfemoral procedures). The collective was analyzed with respect to complications, reinfection rate and clinical status at the end of the interim phase. Results of an endofemoral and transfemoral approach were compared.RESULTS: With a median Staffelstein-Score of 60 (range 31-81) at the end of the interim phase, the first clinical results are promising. The reinfection-free rate after a median follow-up of 50 months was 90%. Spacer-related complications occurred in 8% of the total collective. Comparing the endo- and transfemoral procedure, there were no statistical differences in complications or regarding the clinical and infectiological outcome.CONCLUSIONS: In this study, we were able to show good clinical results for the presented spacer technique. With no relevant difference in outcome, the decision for an endofemoral or transfemoral technique can be based on technical deliberations. Further prospective comparative studies are necessary to show the clinical benefit of this procedure.
KW - Humans
KW - Arthroplasty, Replacement, Hip/adverse effects
KW - Prosthesis-Related Infections/surgery
KW - Retrospective Studies
KW - Anti-Bacterial Agents/therapeutic use
KW - Bone Cements
KW - Reoperation/methods
KW - Treatment Outcome
U2 - 10.1007/s00402-022-04748-z
DO - 10.1007/s00402-022-04748-z
M3 - SCORING: Journal article
C2 - 36604321
VL - 143
SP - 5395
EP - 5403
JO - ARCH ORTHOP TRAUM SU
JF - ARCH ORTHOP TRAUM SU
SN - 0936-8051
IS - 8
ER -